The Affordable Care Act of 2010 offers options & financial incentives for states seeking to expand systems of long-term services and supports. Many of these opportunities work together & build on existing initiatives, resulting in a strengthened infrastructure for service provision & an LTSS system that meets the needs of Medicaid beneficiaries. Key provisions of the ACA are summarized in this issue brief, followed by considerations for states seeking to take advantage of new opportunities.

The Affordable Care Act of 2010 offers a number of options and financial incentives for states seeking to expand their systems of long-term services and supports. Many of these opportunities can be leveraged to work together and to build on existing initiatives. Key provisions of the ACA are summarized, followed by considerations for states seeking to take advantage of these new opportunities.

States are curtailing optional services, extending waiting lists, cutting provider reimbursement, and taking other measures to cope with the worst economic downturn in 70 years according to a comprehensive 50 state survey. Even as state revenues shrink, the demand for services is increasing. On a brighter note, many states may participate in expanded HCBS services through ACA opportunities. Review preliminary findings presented at the National HCBS Conference in September, 2010.

Discover strategies that were used to successfully engage local leaders and related agencies to host well attended and highly regarded Senior Benefits Expos across Massachusetts. Eight Expos were held across the state to inform and connect people to the programs and services they need, and provide them with the opportunity for on-the-spot screening and enrollment. The greatest success factor was believed to be the effective partnerships between federal, local and state agencies.

Read the main findings of an online survey of State Units on Aging (SUAs) and Area Agencies on Aging (AAAs) on the use of online screening and application tools to help seniors and younger adults with disabilities to enroll in public benefits. The results show that the majority use online screening and application technology to support their counseling and enrollment activities, and that using these technologies have benefited their organization and their clients.

Interested in the work and current challenges that face The National Association of State Units on Aging members? This report, resulting from a February through April 2009 NASUA survey, was given to its members to obtain a snapshot of their work and the current challenges they face. The results, divided into 10 themes, provide that snapshot as well as the states’ perspective on the evolution of the aging network as it works to redesign the long-term care delivery system.

The findings from a fourth economic survey of the state units on aging conducted in May 09 revealed that despite the funding provided by the American Recovery and Reinvestment Act of 2009, 60% of states must reduce their agencies' budgets for FY10. While ARRA funding allowed states to maintain food and nutrition programs, over 20% of states indicated they will cut back services and programs include Older Americans Act, disability, Medicaid, and home- and community-based services and supports.

In FY09, 27 states expect budget shortfalls at the same time that HCBS and other services administered by State Units on Aging nationwide experience increased demand. NASUA surveyed 44 states and the District of Columbia about their strategies for coping with this situation. These include creating or increasing waiting lists, cutting budgets, reduced staffing and travel, and adjusting program elements such as eligibility.

The goal of this coordinated national campaign from n4a & NASUA is to provide the resources to implement consumer-centered and cost effective long-term care strategies authorized in the 2006 reauthorization of the Older Americans Act. Empower the Aging Services Network to implement these strategies through a three-pronged program encompassing person centered access to information, evidence-based disease management and health promotion activities, and enhanced home and community-based services.

This paper explores the role of older participants in planning, developing and overseeing home and community based service (HCBS) programs. It seeks to help State Units on Aging and others in the aging network identify concrete steps they can take to support the role of these older individuals as public policy advocates. The report addresses the extent of older HCBS participants' current involvement, the barriers to success, and the strategies being used to attain participation.